Tackling malaria in Africa has had “great successes” but the world must “not take the foot off the gas”, doctors warn.

Their detailed analysis of the disease, published in the Lancet, shows 184 million people still live in areas where more than half of children show signs of malarial infection.

But they say “a lot more needs to be done” in high-risk areas.

Globally 627,000 people die from malaria each year, mostly in Africa.

The Wellcome Trust researchers analysed data from 26,746 community studies involving more than 3.5 million people from 44 countries in Africa.

They plotted the proportion of two to 10-year-olds carrying malarial parasites. Children are most at risk before immunity to the parasite starts to develop.

Not all cases will lead to disease, but it gives a clear idea of the prevalence of malaria.

The dark green areas show the high prevalence of malaria in central Africa

The research showed that between 2000 and 2010 there was a fall in the prevalence of malaria in 40 of the countries studied.

The number of people in high transmission areas (which have more than 50% of children carrying malarial parasites) fell from 218 million to 184 million.

Uganda and Democratic Republic of Congo have some of the highest malaria prevalence figures in Africa.

One of the researchers, Dr Abdisalan Mohamed Noor, of the Kenya Medical Research Institute Wellcome Trust Research Programme, told the BBC: “It’s a mixed message. It has been a great success in several countries, but more needs to be done.

‘Proven interventions’

“Drug and insecticide resistance are a big threat to the gains made so far, and we need to be careful not to take the foot off the gas, thinking it’s no longer a problem.”

Commenting on the findings, Prof Brian Greenwood, of the London School of Hygiene and Tropical Medicine, and Dr Kwadwo Koram, of the Noguchi Memorial Institute of Medical Research in Ghana, said: “The reductions in malaria transmission that have been achieved in much of sub-Saharan Africa, although encouraging, have been only modest.

“More could be done to improve malaria control in high-risk countries by increasing coverage with proven interventions, such as insecticide-treated nets and chemoprevention.”

A 3D filming technique which captures the corkscrew motion of malaria sperm has been developed by Edinburgh University scientists.

The moving digital holograms have given new insights into how the sperm moves more freely than had been thought.

Understanding how malaria parasites mate could pave the way for improved prevention and control of the disease.

Malaria parasites mate in the gut of mosquitoes and people catch the disease when they are bitten.

Female mates

Researchers from Edinburgh University and the Rowland Institute at Harvard University were able to see malaria sperm move in an irregular, lopsided corkscrew motion, which allows them to twist to the left or the right, as well as go forwards and backwards.

“

Malaria sperm, and similar organisms, have greater freedom of movement than was previously thought”

Dr Sarah ReeceEdinburgh University

The motion is thought to help the sperm swim between red blood cells to find female mates.

Malaria sperm use microscopic structures, called flagella, to swim.

The structures are important because they are used by many parasites to invade parts of the body.

They also perform essential roles in embryonic development, reproduction, and nutrient uptake in all animals.

Scientists said the simple structure of the malaria sperm makes it an excellent model system to study flagella in animals.

Dr Sarah Reece, an Edinburgh University royal society fellow, said: “Findings gained using our unique system provide us with a better understanding of how malaria parasites mate and spread this deadly disease, and have revealed that malaria sperm, and similar organisms, have greater freedom of movement than was previously thought.”

The study, published in the Proceedings of the National Academy of Sciences, was funded by the Rowland Institute at Harvard, the Natural Environmental Research Council, the Wellcome Trust, the Royal Society, and Edinburgh University.

The statement said that the hope now is that the Geneva-based World Health Organization (WHO) may recommend the use of the RTS,S vaccine from as early as 2015 if EMA drugs regulators back its licence application.

Testing showed that 18 months after vaccination, children aged five to 17 months had a 46% reduction in the risk of clinical malaria compared to unvaccinated contemporaries.

But in infants aged six to 12 weeks at the time of vaccination, there was only a 27% reduction in risk.

A spokeswoman for GSK told the AFP news agency that the company would file its application to the EMA under a process aimed at facilitating new drugs for poorer countries.

UK politician Lynne Featherstone, International Development Minister, said: “Malaria is not just one of the world’s biggest killers of children, it also burdens health systems, hinders children’s development and puts a brake on economic growth. An effective malaria vaccine would have an enormous impact on the developing world.

“We welcome the scientific progress made by this research and look forward to seeing the full results in due course.”

A new report says targeting mosquito breeding sites is likely to be increasingly necessary to reduce cases of malaria in Africa and Asia.

Researchers say that with mosquitoes becoming ever more resistant to insecticides, new approaches will be needed to help control the disease.

They include flushing out stagnant water where mosquito larvae grow and treating water with chemicals.

More than 600,000 people died from the malaria in 2010, most African children.

The number of deaths from malaria has fallen by a quarter in the last decade, largely thanks to the widespread distribution of mosquito nets treated with insecticides and the use of indoor insecticides sprays.

But the insects are becoming increasingly resistant to these chemicals, so a new report by researchers at the London School of Hygiene and Tropical Medicine says authorities should also use a method called “larval source management”.

This is where mosquito larvae found in stagnant water like paddy fields or ditches are killed off by draining or flushing the land before they get a chance to develop. It also involves something called larviciding where chemicals are added to standing water.

The study found evidence that the method may significantly reduce both the number of cases of malaria by up to 75% and the proportion of people infected with the malaria parasite by up to 90% when used in appropriate settings.

The report’s authors trawled through thousands of studies looking at the effectiveness of this method and found 13 which reached a high enough standard to draw their conclusions. The research came from countries including The Gambia, Kenya, Mali and the Philippines.

The report’s author Lucy Tusting says the findings have important implications for malaria control policy

“The tremendous progress made in malaria control in the last decade is now threatened by mosquito resistance to the insecticides available for long-lasting insecticide treated nets and indoor residual spraying.” she says

Our research shows that larval source management could be an effective supplementary intervention in some places.”

The World Health Organization says the research is not robust enough to support this method, and it is not recommended for use in rural areas where breeding grounds are hard to find.

A WHO spokesperson said: “Until there is more compelling evidence, larval control should continue to be viewed as a supplementary measure for malaria control in carefully selected settings. Promoting the widespread use of larval source management in rural areas of sub-Saharan Africa would be premature.”

The WHO says larval source management should only be used alongside insecticide sprays and nets.

The UK is hoping to halve the number of malaria deaths in 10 target countries by 2015

Not enough anti-malarial bed nets paid for by the UK are being used around the world, ministers have been warned.

The UK has funded 25 million mosquito nets since 2010 but the National Audit Office said usage among target groups, such as children, was disappointing.

The watchdog urged the UK to work with aid recipients to “change attitudes” and to ensure proper value for money.

Ministers said the increased use of bed nets was part of a multi-faceted strategy acknowledged to save lives.

There is no vaccine for malaria and the disease killed an estimated 660,000 people last year and left 250 million people seriously ill.

The World Health Organization has warned of a $2.8bn shortfall in global funding to tackle the disease, regarded as one of the biggest health and economic challenges for countries with high rates of illness.

“

It is important that the department influence the governments of countries receiving malaria aid so that their efforts to tackle the disease match its own rising spending”

Amyas MorseNational Audit Office

The UK spent £252m in 2011-12 on counter-prevention measures in 18 countries, 16 of them in Africa. The budget is expected to rise to £494m in 2014-15, making the UK the third largest global donor.

The NAO’s report, which drew on first-hand research in Sierra Leone, Tanzania, Nigeria and Burma, said the countries had been “well-chosen” but questioned the effectiveness of some of the spending.

There had been a 23% increase in the number of families in the four countries owning a mosquito net since 2010 but usage by target groups such as children had increased by just 11.6%.

A target for 80% of children under five to sleep under bed nets by 2015 was in danger of being missed, it added, and better monitoring was needed of how many nets were used and how long they lasted.

‘Rapid resurgence’

Mortality rates from malaria in Africa have dropped by a third in the past decade but the NAO warned this progress was at risk of stalling and there could be “a rapid resurgence of the disease”.

COUNTRIES RECEIVING UK AID

Burma

Zimbabwe

Tanzania

India

Malawi

Ghana

Rwanda

Somalia

Nigeria

Democratic Republic of Congo

Uganda

Zambia

Burundi

Ethiopia

Kenya

Mozambique

Sierra Leone

Sudan

With some nets wrongly sized and difficult to hang, persuading the most vulnerable to use them was as much of a challenge as providing them in the first place, the watchdog said.

“Bilateral programmes use proven interventions, such as providing bed nets, and funding the introduction of rapid diagnostic tests and the distribution of drugs,” said its head Amyas Morse.

“But sustained improvement will crucially depend on changing the attitudes and behaviour of the populations at risk.

“It is important that the department influence the governments of countries receiving malaria aid so that their efforts to tackle the disease match its own rising spending.”

Campaign group Malaria No More said the NAO’s conclusions were based on “a few countries” and the issue of 12 million nets in Ghana had produced “encouraging” results with reported usage among children up sharply.

“We know what works and thanks to the simple, cost-effective means at our disposal, global malaria death rates have been cut by 26% between 2000-2010,” said its director James Whiting.

International Development Secretary Justine Greening said the watchdog’s report had recognised that the UK’s programmes saved lives and represented good value for money.

“Less disease and healthier populations make for more stable, productive and ultimately self-sufficient developing economies,” she said. “The UK is playing its part by improving access to life-saving drugs, increasing the use of bed nets and investing in developing new technologies to tackle malaria and reduce the spread of resistance.”

SINGAPORE – Officials were quick to deny talk of a malaria outbreak at the Sentosa Golf Club (SGC) on Saturday after American crowd favourite Natalie Gulbis joined South Korean trailblazer Pak Se Ri in pulling out of the HSBC Women’s Champions due to illness.

Fears of an outbreak swirled after coach Butch Harmon, who formerly coached Tiger Woods, tweeted that his current charge Gulbis, and Pak, who is now back in South Korea, were “put in the hospital in Singapore with malaria. Hope they both will be ok”.

But the LPGA Tour insisted otherwise.

“Pak withdrew this week due to illness. She does not have malaria, just flu-like symptoms,” said a spokesman, on the five-time Major winner who withdrew last Wednesday.

The LPGA also added that several of its rules officials had also fallen ill, but they too have not been diagnosed with malaria, and were still going about their duties.

Gulbis, on the other hand, was still awaiting blood-test results.

But she was at the SGC on Saturday, and did not appear to be seriously ill. She is expected to fly back to the United States today.

“She’s not feeling well,” said Mr David Livingston, her agent at IMG. “She does have flu-like symptoms, but, to be clear, she has not been hospitalised and there is no diagnosis of malaria.”

The field at the premier event, being played at the SGC’s Serapong course, is now down to 60, as former world No.1 Ai Miyazato of Japan also pulled out last Wednesday.

She had been suffering from whiplash, the result of being involved in a five-car pile up while she and two other golfers, Suzann Pettersen of Norway and American Paula Creamer, were on their way to Bangkok’s airport for their flight to Singapore.

But a sore shoulder from the crash has not stopped Creamer from keeping herself in contention for today’s climax.

She trails co-leaders – world No. 2 Choi Na Yeon of South Korea and American Stacy Lewis – by just two strokes. Said Creamer: “It’s going to make for a very exciting Sunday.”